| NPI | 1023210945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD H70799) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OT011574) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2011-06-03 |